Latest Guidance Update
September 2023: Changes were made to align this quality standard with the updated NICE guideline on spinal metastases and metastatic spinal cord compression. Statement 1 on information about recognising the symptoms of metastatic spinal cord compression for adults at high risk has been removed because it is no longer supported by the guideline recommendations. Statements 3 and 6 have been updated to reflect changes to the guidance on imaging and treatment. Links, definitions and source guidance sections have also been updated throughout. NICE have also updated the name of this quality standard.
This specialist Guidelines summary covers statements for the diagnosis and management of spinal metastases and metastatic spinal cord compression (MSCC). It describes high-quality care in priority areas for improvement.
This summary is for use by oncology teams. For information on rationales and quality measures, refer to the original quality standard (QS56) from NICE.
List of Quality Statements
Quality Statement 1: Information About Recognising the Symptoms of Metastatic Spinal Cord Compression
- This statement has been removed. For more details see update information from September 2023.
- Adults with spinal pain suggestive of spinal metastases, but with no neurological symptoms or signs, have magnetic resonance imaging (MRI) of the whole spine and any necessary treatment plan agreed within 1 week of the suspected diagnosis.
Quality Statement 3: Imaging for Adults with Suspected Metastatic Spinal Cord Compression
- Adults with suspected MSCC who present with neurological symptoms or signs have an MRI of the whole spine within 24 hours of the suspected diagnosis.
- Adults with suspected MSCC who present with neurological symptoms or signs have their diagnostic investigations coordinated by an MSCC coordinator.
Quality Statement 5: Coordinating Care for Adults with Metastatic Spinal Cord Compression
- Adults with MSCC have their ongoing care coordinated by an MSCC coordinator.
- Adults with MSCC that is not suitable for surgery start radiotherapy within 24 hours of the decision to treat (if appropriate).
Quality Statement 7: Supportive Care and Rehabilitation
- Adults with MSCC have a management plan that includes an assessment of ongoing care and rehabilitation needs.